How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $181.97 | Professional | None | $112.20 | $125.89 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $186.21 | Professional | None | $102.33 | $141.25 | $186.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $208.93 Typical High $281.84 | Professional | 50 · Both sides | $151.36 | $208.93 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $177.83 Typical High $229.09 | Facility | None | $51.29 | $177.83 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $269.15 | Professional | None | $123.03 | $173.78 | $269.15 |
ConnectiCare Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $218.78 | Professional | None | $162.18 | $181.97 | $218.78 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $331.13 | Professional | None | $74.13 | $144.54 | $331.13 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $63.10 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.12 Typical High $36.31 | Professional | 53 · Discontinued | $22.39 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.62 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $18.62 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.59 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $18.20 |
Where Connecticut sits
The same service costs 3.5 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 13th of 51
$148
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.